Monday, June 28, 2010

Lab results

The endocrinologist called with Summer’s lab results from the tests we had run last week. Everything came back mostly normal.

Her sodium levels were normal, which indicates she still doesn’t have Diabetes Insipidus.

Her thyroid was slightly elevated, which is not an actual concern. If her thyroid levels had been affected by the surgery or tumor, we would have seen the opposite problem – her thyroid would have been low. An elevated thyroid level is common in someone who is or has been sick, which Summer had been the few days prior to the blood draw.

Her unstimulated morning cortisol level was in the normal range, so nothing to worry about (in theory) there. More about that later.

They tested two indicators of growth hormone, and one came back ever-so-slightly low, while the other was fine. The endocrinologist isn’t worried about this just yet because the ‘normal’ range is very loosely defined for Summer’s age group. Depending on whether she is going through a growth spurt at the time or a number of other things, the level might be a little high or low. We’ll just continue to monitor her growth closely, and keep checking her against the height and weight curves she’s been on to date.

So, her lab results came back with no major red flags. However, the endocrinologist was a little concerned about the fluctuating activity, fatigue and overall crankiness levels we had seen the oncologist about last week. She said that the cyclic nature of her behavior changes could be attributed to illness, as the oncologist explained, but it could also be a problem with her cortisol levels.

You’ll remember I said above that her cortisol level was in the normal range. Well, unstimulated, it is. But it could be that her body isn’t stimulating the production of additional cortisol when it needs it to deal with stress (not just stress as we adults think of it, but stress from too much physical activity, illness, or not getting enough sleep, etc).

We saw a huge example of this over the weekend. Summer played hard for two hours at a Gymboree birthday party, and then absolutely crashed afterward. She didn’t want anybody to look at or talk to her, except me, and was a complete wreck for about an hour and a half until she finally fell asleep. We’ll keep an eye out for these patterns over the coming week, and then we’ll check in with the endocrinologist to determine whether we need more tests.

I’m anxious to bring her back to her play class at MyGym because she loves them so much, and is always singing the “Hi, hi how do you do” and “Goodbye” songs to me, but we’ll need to get this stress-level stuff sorted out first. It would be too hard on her (and me!) to deal with that sort of aftermath every weekend.

The test they’d likely run would be the stimulation test like the one they did a few weeks back where they injected something into her body that should stimulate cortisol production, and then draw blood after 30 and 60 minutes to test the levels and see how she’s responding. It’s not a fun test, but a necessary evil.

If she does have a cortisol problem, we can supplement it with pills as needed to help get her what her body isn’t producing.

In other news, Summer continues to LOVE the swings and pretty much never wants to get off of them. She also now loves to jump off of things (eek!). I think these are pretty good signs that her vision is at least holding steady for now.

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